Question

Mrs. Jones brings her toddler James to the clinic. She says that James has not been feeling well all week. He has had a fever and has been vomiting for the past two days. Upon assessment you note that James has dry mucous membranes, cracked lips, swollen red throat with white patches, temperature of 102.7. His skin is also warm and dry. James also has a pulse rate of 130.

Question 1

Why do you think James has a high pulse rate?

Question 2

At this time, what are the priorities of care?

Question 3

What are three SMART goals that you would have for James right now?

Answer 1

1. James has high pulse rate as his body temperature is 102.7, as increased temperature increases the heart rate as the body is trying to decrease the body heat.

2. Firstly temperature should be reduced an antipyretics may be administered, secondly patient should be hydrated with dns 0.45 % and ORS may also be ordered. Lastly an antibiotics should be started.

• 3. First goal should be to decrease the body temperature.
• Patient is dehydrated, hence patient should be hydrated.
• Swollen red throat and white patches indicates bacterial infection, hence a proper test to confirm should be ordered.
• Once the blood test confirms, antibiotics which is resistant to the bacteria should be started.